Kristie Butler, RD

Individual provider Active NPI Registered Dietitian · Neenah, WI

NPI 1396258257 · NPPES record last updated Nov 13, 2017

Key facts

NPI
1396258257
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
1062258 (WI)
Practice address
419 Park Dr
Neenah, WI 54956-2858
Phone
(561) 459-9750
NPI assigned
Nov 13, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1062258WIMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian
Group: 193400000X SINGLE SPECIALTY GROUP
133V00000X 1062258 WI Yes

Addresses

Primary practice location

419 Park Dr
Neenah, WI 54956-2858

Mailing address

419 Park Dr
Neenah, WI 54956-2858
Phone (561) 459-9750

Other providers in Neenah, WI

All providers in Neenah, WI · Registered Dietitian in Wisconsin

Sources for this page

Verify at the official NPI Registry.